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斉藤　仁志 (サイトウ　ヒトシ)

北海道大学病院　中央診療施設等　集中治療部講師

研究者基本情報

■ 学位
  • 医学博士, 北海道大学
■ URL
researchmap URLホームページURL■ ID 各種
研究者番号
  • 10455694
J-Global ID■ 研究キーワード・分野
研究分野
  • ライフサイエンス, 麻酔科学
■ 担当教育組織

経歴

■ 経歴
委員歴
  • 2019年04月 - 現在
    日本集中治療医学会, 代議員
  • 2018年04月 - 現在
    日本麻酔科学会, 評議員, 学協会

研究活動情報

■ 論文
  • 小児における血管内皮グリコカリックス測定部位の検討 GlycoCheckを用いて
    白石 真大; 泉 岳; 斉藤 仁志; 加藤 裕貴; 糸洲 佑介; 土岐 崇幸; 佐藤 逸美; 加藤 伸康; 森本 裕二
    日本集中治療医学会雑誌, 32, Suppl.2, S602, S602, (一社)日本集中治療医学会, 2025年09月
    日本語
  • フォンタン循環が微小循環に与える影響 血管内皮グリコカリックスへの負荷
    白石 真大; 泉 岳; 山澤 弘洲; 武田 充人; 加藤 伸康; 加藤 裕貴; 土岐 崇幸; 糸洲 佑介; 斉藤 仁志; 森本 裕二
    日本小児循環器学会総会・学術集会抄録集, 61回, I, 01, (NPO)日本小児循環器学会, 2025年07月
    日本語
  • Acute decompensated right heart failure potentially triggered by multiple factors including pulmonary vasodilator removal during plasma exchange: a case report.
    Takayuki Toki; Kazuyuki Mizunoya; Misa Itabashi; Naoki Nishikawa; Koji Hoshino; Hitoshi Saito; Yuji Morimoto
    JA clinical reports, 11, 1, 5, 5, 2025年01月27日, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: Plasma exchange (PE) removes high-molecular-weight substances and is sometimes used for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with alveolar hemorrhage. Hypotension during PE is rare, except in allergic cases. We report a case of shock likely caused by increased pulmonary vascular resistance (PVR) during PE. CASE PRESENTATION: A 66-year-old man with pulmonary hypertension (PH) and glomerulonephritis was admitted with dyspnea. He had discontinued sildenafil prior to admission. Alveolar hemorrhage associated with AAV was suspected, and PE was performed. Soon after, he developed circulatory failure and hyperlactatemia. Echocardiography revealed right ventricular dilation, suggesting increased PVR. Inhaled nitric oxide (iNO) was administered, rapidly improving hyperlactatemia and oxygenation. The shock observed during PE was attributed to multiple factors, including the potential removal of sildenafil, which may have led to an increase in PVR. CONCLUSIONS: The shock was attributable to acute right heart failure caused by an exacerbation of PH, possibly due to sildenafil removal via PE, although other contributing factors could not be excluded.
  • Bronchoalveolar Lavage Fluid Analysis in Severe COVID-19: Insights Into Cellular and Microbiological Characteristics.
    Junya Hagiwara; Ryuichi Nakayama; Naofumi Bunya; Arisa Aoyagi; Keigo Sawamoto; Shuji Uemura; Hitoshi Saito; Eichi Narimatsu
    Acute medicine & surgery, 12, 1, e70091, 2025年, ［国際誌］
    英語, 研究論文（学術雑誌）, INTRODUCTION: This study aimed to describe bronchoalveolar lavage fluid (BALF) findings in cases of refractory respiratory failure, despite standard treatment, among patients with severe coronavirus disease 2019 (COVID-19), compare BALF findings between patients with mechanical ventilation (MV) weaning success and those with failure within 28 days, and evaluate the safety and impact on respiratory mechanics of BALF examination in patients with severe COVID-19. METHODS: This study was conducted at the Department of Emergency Medicine, Sapporo Medical University, Japan. We included 21 patients with concurrent severe COVID-19 and refractory respiratory failure who could not be weaned from MV despite standard treatment. We compared BALF cellular composition and culture results between patients who were successfully weaned from MV within 28 days and those who were not. Respiratory mechanics before and after BALF collection were also evaluated. RESULTS: BALF analysis revealed a mixed cellular pattern with a median total cell count of 174/μL (interquartile range [IQR], 104-400/μL). The successfully weaned group showed significantly higher macrophage percentages (24.7% vs. 3.5%, p = 0.034) and counts (56.4 vs. 10.5/μL, p = 0.024) than did the failure group. The failure group had higher neutrophil proportions (34.4% vs. 8.5%, p = 0.098). Positive cultures were found in 42.9% of patients. No deterioration in respiratory mechanics was observed after BALF. CONCLUSIONS: BALF analysis revealed a mixed cellular pattern. The successfully weaned group had significantly higher macrophage percentages and counts. BALF examination can be safely performed in patients with severe COVID-19.
  • Cerebral oxygenation saturation in childhood: difference by age and comparison of two cerebral oximetry algorithms.
    Yasunori Kubo; Yusuke Itosu; Tomonori Kubo; Hitoshi Saito; Kazufumi Okada; Yoichi M Ito; Yuji Morimoto
    Journal of clinical monitoring and computing, 38, 3, 639, 648, 2024年06月, ［国際誌］
    英語, 研究論文（学術雑誌）, Few reports are available on the monitoring of regional cerebral oxygen saturation (rSO2) in pediatric patients undergoing non-cardiac surgical procedures. In addition, no study has examined the rSO2 levels in children of a broad age range. In this study, we aimed to assess and compare rSO2 levels in pediatric patients of different age groups undergoing non-cardiac surgery. We used two oximeters, tNIRS-1, which uses time-resolved spectroscopy, and conventional INVOS 5100C. Seventy-eight children-26 infants, 26 toddlers, and 26 schoolchildren-undergoing non-cardiac surgery were included. We investigated the differences in the rSO2 levels among the age groups and the correlation between the models and physiological factors influencing the rSO2 values. rSO2 measured by INVOS 5100C was significantly lower in infants than those in other patients. rSO2 measured by tNIRS-1 was higher in the toddler group than those in the other groups. The rSO2 values of tNIRS-1 and INVOS 5100C were moderately correlated (r = 0.41); however, those of INVOS 5100C were approximately 20% higher, and a ceiling effect was observed. The values in INVOS 5100C and tNIRS-1 were affected by blood pressure and the minimum alveolar concentration of sevoflurane, respectively. In pediatric patients undergoing non-cardiac surgery, rSO2 values differed across the three age groups, and the pattern of these differences varied between the two oximeters employing different algorithms. Further research must be conducted to clarify cerebral oxygenation in children.
  • Acquired laryngomalacia as a cause of post-extubation stridor and extubation failure following craniotomy: a case report.
    Kazuyuki Mizunoya; Keisyu Onodera; Yuki Takahashi; Takayuki Toki; Hitoshi Saito; Yuji Morimoto
    JA clinical reports, 9, 1, 44, 44, 2023年07月15日, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: Laryngomalacia is a dynamic airway condition characterized by flaccid laryngeal tissue and inward collapse of supraglottic structures during inspiration. Although it may cause airway obstruction and requires careful management, there have been few reports regarding laryngomalacia after surgery. We report a case of adult-onset laryngomalacia occurred after craniotomy requiring reintubation. CASE PRESENTATION: A 21-year-old man was admitted to the ICU after craniotomy for a cerebellopontine angle tumor. He developed severe stridor immediately after extubation on the postoperative day 2 and required reintubation. On the postoperative day 5, similar episode occurred following re-extubation and fiberoptic laryngoscopy revealed a collapsed epiglottis and left arytenoid into the glottis. A diagnosis of laryngomalacia was made, and he underwent tracheostomy. Laryngomalacia had completely improved; however, bilateral vocal cord paralysis was detected 2 weeks later. CONCLUSIONS: Acquired laryngomalacia should be considered as a possible mechanism of the airway symptoms in a patient with neurological dysfunction.
  • 大動脈縮窄・離断症に対する大動脈弓形成手術後気道出血発症のリスク因子
    泉 岳; 斉藤 仁志; 加藤 裕貴; 水野谷 和之; 糸洲 佑介; 西川 直樹; 武田 充人; 山澤 弘州; 加藤 伸康; 森本 裕二
    日本集中治療医学会雑誌, 30, Suppl.1, S648, S648, (一社)日本集中治療医学会, 2023年06月
    日本語
  • 気管支内視鏡で診断した開頭腫瘍摘出術後発症の成人混合型喉頭軟化症の一症例
    高橋悠希; 水野谷和之; 斉藤仁志
    日本集中治療医学会学術集会(Web), 50th, Suppl.1, S590, S590, (一社)日本集中治療医学会, 2023年06月
    日本語
  • 大動脈縮窄・離断症に対する大動脈弓形成手術後気道出血発症のリスク因子
    泉岳; 斉藤仁志; 加藤裕貴; 水野谷和之; 糸洲佑介; 西川直樹; 武田充人; 山澤弘州; 加藤伸康; 森本裕二
    日本集中治療医学会学術集会(Web), 50th, Suppl.1, S648, S648, (一社)日本集中治療医学会, 2023年06月
    日本語
  • Effect of cerebrospinal fluid drainage pressure in descending and thoracoabdominal aortic repair: a prospective multicenter observational study.
    Kenji Yoshitani; Soshiro Ogata; Shinya Kato; Akito Tsukinaga; Tsunenori Takatani; Nobuhide Kin; Mariko Ezaka; Jun Shimizu; Yuko Furuichi; Shoichi Uezono; Kotaro Kida; Katsuhiro Seo; Shinichi Kakumoto; Hiroshi Miyawaki; Mikito Kawamata; Satoshi Tanaka; Manabu Kakinohana; Shunsuke Izumi; Hiroyuki Uchino; Takayasu Kakinuma; Kimitoshi Nishiwaki; Kazuko Hasegawa; Mishiya Matsumoto; Kazuyoshi Ishida; Atsuo Yamashita; Michiaki Yamakage; Yusuke Yoshikawa; Yuji Morimoto; Hitoshi Saito; Takahisa Goto; Tetsuhito Masubuchi; Masahiko Kawaguchi; Kosuke Tsubaki; Satoshi Mizobuchi; Norihiko Obata; Yoshimi Inagaki; Kazumi Funaki; Yoshiki Ishiguro; Masamitsu Sanui; Kazutaka Taniguchi; Kunihiro Nishimura; Yoshihiko Ohnishi
    Journal of anesthesia, 37, 3, 408, 415, 2023年06月, ［国内誌］
    英語, 研究論文（学術雑誌）, PURPOSE: Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed. We hypothesize that CSFD at higher pressures is effective for preventing motor deficits. METHODS: This prospective observational study included 14 hospitals that are members of the Japanese Society of Cardiovascular Anesthesiologists. Patients who underwent thoracic and thoracoabdominal aortic repair were divided into four groups: Group 1, CSF pressure around 10 mmHg; Group 2, CSF pressure around 15 mmHg; Group 3, CSFD initiated when motor evoked potential amplitudes decreased; and Group 4, no CSFD. We assessed the association between the CSFD group and motor deficits using mixed-effects logistic regression with a random intercept for the institution. RESULTS: Of 1072 patients in the study, 84 patients (open surgery, 51; thoracic endovascular aortic repair, 33) had motor deficits at discharge. Groups 1 and 2 were not associated with motor deficits (Group 1, odds ratio (OR): 1.53, 95% confidence interval (95% CI): 0.71-3.29, p = 0.276; Group 2, OR: 1.73, 95% CI: 0.62-4.82) when compared with Group 4. Group 3 was significantly more prone to motor deficits than Group 4 (OR: 2.56, 95% CI: 1.27-5.17, p = 0.009). CONCLUSION: CSFD is not associated with motor deficits in thoracic and thoracoabdominal aortic repair with CSF pressure around 10 or 15 mmHg.
  • 肝胆膵手術後患者における過大腎クリアランス発生に関する検討 症例対照研究
    中峯 奈央子; 水野谷 和之; 佐々木 慶子; 出村 理海; 斉藤 仁志; 森本 裕二
    日本集中治療医学会雑誌, 30, 3, 171, 177, (一社)日本集中治療医学会, 2023年05月
    日本語
  • 全身麻酔中の肺保護換気
    水野谷和之; 斉藤仁志; 森本裕二
    麻酔, 71, 10, 1068, 1075, 克誠堂出版(株), 2022年10月
    日本語
  • Perioperative junctional ectopic tachycardia associated with congenital heart disease: risk factors and appropriate interventions.
    Gaku Izumi; Atsuhito Takeda; Hirokuni Yamazawa; Nobuyasu Kato; Hiroki Kato; Tsuyoshi Tachibana; Osamu Sagae; Ryogo Yahagi; Motoki Maeno; Koji Hoshino; Hitoshi Saito
    Heart and vessels, 37, 10, 1792, 1800, 2022年10月, ［国内誌］
    英語, 研究論文（学術雑誌）, The risk factors and the appropriate interventions for perioperative junctional ectopic tachycardia (JET) in congenital heart disease (CHD) surgery have not been sufficiently investigated despite the severity of this complication. This study aimed to examine the risk factors and interventions for perioperative JET. From 2013 to 2020, 1062 surgeries for CHD (median patient age: 4.3 years, range 0.0-53.0) with or without a cardiopulmonary bypass (CPB) were performed at Hokkaido University, Japan. We investigated the correlation between perioperative JET morbidity factors, such as age, genetic background, CPB/aortic cross-clamp (ACC) time, use of inotropes and dexmedetomidine, STAT score, and laboratory indices. The efficacy of JET therapies was also evaluated. Of the 1062 patients, 86 (8.1%) developed JET. The 30-day mortality was significantly high in JET groups (7% vs. 0.8%). The independent risk factors for JET included heterotaxy syndrome [odds ratio (OR) 4.83; 95% confidence interval (CI) 2.18-10.07], ACC time exceeding 90 min (OR 1.90; CI 1.27-2.39), and the use of 3 or more inotropes (OR 4.11; CI 3.02-5.60). The combination of anti-arrhythmic drugs and a temporary pacemaker was the most effective therapy for intractable JET. Perioperative JET after CHD surgery remains a common cause of mortality. Inotrope use was a risk factor for developing JET overall surgery risk. In short ACC surgeries, heterotaxy syndrome could increase the risk of JET, which could develop even without inotrope use in long ACC surgeries. It is crucial not to delay the treatment in cases with unstable hemodynamics caused by this arrhythmia. It is recommended to reduce numbers not dose of inotropes.
  • Intraoperative myocardial infarction and refractory cardiogenic shock during major hepatectomy: a case report.
    Yasunori Yagi; Kazuyuki Mizunoya; Toshihiro Mori; Hitoshi Saito; Yuji Morimoto
    JA clinical reports, 8, 1, 19, 19, 2022年03月09日, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: Myocardial infarction (MI) complicated by cardiogenic shock during non-cardiac surgery is a rare but fatal complication. The management of intraoperative MI is challenging. CASE PRESENTATION: A 77-year-old hypertensive man with good functional capacity was scheduled for hepatectomy. After the start of liver resection, the electrocardiogram monitor showed ST depression, and the patient developed refractory cardiogenic shock. Transesophageal echocardiography revealed severe hypokinesis of the anteroseptal wall. The surgery was suspended, and an intra-aortic balloon pump was placed following immediate abdominal closure. Coronary angiography revealed severe stenosis of the left main coronary trunk, and percutaneous coronary intervention (PCI) was performed. Myocardial wall motion improved, and blood pressure stabilized. Two days after PCI, hepatectomy, which had been suspended, was successfully completed. CONCLUSIONS: Once intraoperative MI has occurred, early diagnosis and multidisciplinary approaches are important to manage the difficult clinical situation.
  • Neonatal isoflurane exposure disturbs granule cell migration in the rat dentate gyrus.
    Yosuke Uchida; Toshikazu Hashimoto; Hitoshi Saito; Koichi Takita; Yuji Morimoto
    Biomedical research (Tokyo, Japan), 43, 1, 1, 9, Biomedical Research Press, 2022年02月17日, ［国内誌］
    英語, 研究論文（学術雑誌）, It has been reported that neonatal isoflurane exposure causes behavioral abnormalities following neurodegeneration in animals and gamma-aminobutyric acid type A (GABAA) receptor activation during the synaptogenesis is considered to be one possible trigger. Additionally, the inhibitory effect of excitatory GABAA receptor signaling on the granule cell (GC) migration in the neonatal rat dentate gyrus (DG) was reported in a febrile seizure model. Then, we hypothesized that neonatal isoflurane exposure, which activates GABAA receptor, causes GC migration disturbances in the neonatal rat. Rat pups were injected with 5-bromo-2'-deoxyuridine (BrdU) and divided into five treatment groups, and double immunofluorescent staining targeting BrdU and homeobox prospero-like protein 1 (Prox1) was performed to examine the localization of BrdU/Prox1 colabeled cells, and then the GC migration was assessed. As a result, we found that the ectopic migration of GC after 2% isoflurane exposure on postnatal day 7 significantly increased after P21. The number of hilar ectopic GCs was influenced by the concentration of isoflurane and the exposure day but not by carbon dioxide exposure. Our main finding is that neonatal isoflurane anesthesia disturbs the migration of GCs in the rat DG, which may be one possible mechanism underlying the neurotoxicity following neonatal isoflurane anesthesia.
  • Postoperative thyroid storm after radical nephrectomy for renal cell carcinoma with inferior vena cava tumor thrombus.
    Naoya Iwahara; Takashige Abe; So Nagai; Masanao Yoshino; Hitoshi Saito; Hiromi Okada; Hiroshi Kikuchi; Ryuji Matsumoto; Takahiro Osawa; Nobuo Shinohara
    IJU case reports, 4, 5, 330, 332, 2021年09月, ［国際誌］
    英語, Introduction: Thyroid storm is a rare life-threating condition. We report a case of thyroid storm after radical nephrectomy for renal cell carcinoma with inferior vena cava tumor thrombus. Case presentation: A 76-year-old man with a left renal tumor and tumor thrombus extending into the inferior vena cava underwent left radical nephrectomy and thrombectomy. After the surgery, his postoperative course rapidly deteriorated, including central nervous system disturbance, fever, tachycardia, congestive heart failure, and hepatic manifestation. Thyroid function test revealed perioperative hyperthyroidism. Corticosteroids and inorganic iodide improved his condition, suggesting that he developed thyroid storm after surgery. He was discharged 5 months after surgery and has been free from disease recurrence for more than 2 years. Conclusion: Thyroid storm after surgery is rare. However, this postoperative complication is important because it is fatal if not diagnosed and treated properly.
  • Extremely low 18F-fluorodeoxyglucose uptake in the brain of a patient with metastatic neuroblastoma and its recovery after chemotherapy: A case report.
    Yutaka Hoshino; Minako Sugiyama; Kenji Hirata; Shohei Honda; Hitoshi Saito; Atsushi Manabe; Kohsuke Kudo
    Acta radiologica open, 10, 7, 20584601211026810, 20584601211026810, 2021年07月, ［国際誌］
    英語, Commonly, physiological 18F-fluorodeoxyglucose (FDG) uptake in the brain can be observed in 18F-FDG positron emission tomography. Abnormal uptake of 18F-FDG in the brain suggests disorders of central nervous system. Here, we present a case of extremely low 18F-FDG uptake in the brain of a 4-year-old girl with whole-body metastatic neuroblastoma. Almost missing of physiological 18F-FDG uptake in the brain was ascribed at least partly to the metastatic neuroblastoma. The brain could regain physiological 18F-FDG uptake after chemotherapy.
  • An appraisal of respiratory system compliance in mechanically ventilated covid-19 patients
    Gianluigi Li Bassi; Jacky Y. Suen; Heidi J. Dalton; Nicole White; Sally Shrapnel; Jonathon; P. Fanning; Benoit Liquet; Samuel Hinton; Aapeli Vuorinen; Gareth Booth; Jonathan E. Millar; Simon Forsyth; Mauro Panigada; John Laffey; Daniel Brodie; Eddy Fan; Antoni Torres; Davide Chiumello; Amanda Corley; Alyaa Elhazmi; Carol Hodgson; Shingo Ichiba; Carlos Luna; Srinivas Murthy; Alistair Nichol; Pauline Yeung Ng; Mark Ogino; Antonio Pesenti; Huynh Trung Trieu; John F; Fraser on behalf of; the COVID; Critical Care Consortium
    Critical Care, 25, 119, 199, 199, 2021年, ［査読有り］, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level. METHODS: We designed a retrospective observational cohort study with rapid data gathering from the international COVID-19 Critical Care Consortium study to comprehensively describe CRS-calculated as: tidal volume/[airway plateau pressure-positive end-expiratory pressure (PEEP)]-and its association with ventilatory management and outcomes of COVID-19 patients on mechanical ventilation (MV), admitted to intensive care units (ICU) worldwide. RESULTS: We studied 745 patients from 22 countries, who required admission to the ICU and MV from January 14 to December 31, 2020, and presented at least one value of CRS within the first seven days of MV. Median (IQR) age was 62 (52-71), patients were predominantly males (68%) and from Europe/North and South America (88%). CRS, within 48 h from endotracheal intubation, was available in 649 patients and was neither associated with the duration from onset of symptoms to commencement of MV (p = 0.417) nor with PaO2/FiO2 (p = 0.100). Females presented lower CRS than males (95% CI of CRS difference between females-males: - 11.8 to - 7.4 mL/cmH2O p < 0.001), and although females presented higher body mass index (BMI), association of BMI with CRS was marginal (p = 0.139). Ventilatory management varied across CRS range, resulting in a significant association between CRS and driving pressure (estimated decrease - 0.31 cmH2O/L per mL/cmH20 of CRS, 95% CI - 0.48 to - 0.14, p < 0.001). Overall, 28-day ICU mortality, accounting for the competing risk of being discharged within the period, was 35.6% (SE 1.7). Cox proportional hazard analysis demonstrated that CRS (+ 10 mL/cm H2O) was only associated with being discharge from the ICU within 28 days (HR 1.14, 95% CI 1.02-1.28, p = 0.018). CONCLUSIONS: This multicentre report provides a comprehensive account of CRS in COVID-19 patients on MV. CRS measured within 48 h from commencement of MV has marginal predictive value for 28-day mortality, but was associated with being discharged from ICU within the same period. Trial documentation: Available at https://www.covid-critical.com/study . TRIAL REGISTRATION: ACTRN12620000421932.
  • Interleukin-1β Modulates Synaptic Transmission and Synaptic Plasticity During the Acute Phase of Sepsis in the Senescence-Accelerated Mouse Hippocampus.
    Koji Hoshino; Yuka Uchinami; Yosuke Uchida; Hitoshi Saito; Yuji Morimoto
    Frontiers in aging neuroscience, 13, 637703, 637703, 2021年, ［国際誌］
    英語, 研究論文（学術雑誌）, Background: Aging and pre-existing cognitive impairment are considered to be independent risk factors for sepsis-associated encephalopathy. This study aimed to investigate the manner in which aging and pre-existing cognitive dysfunction modified neuroinflammation, synaptic plasticity, and basal synaptic transmission during the acute phase of sepsis using Senescence-Accelerated Mice Prone 8 (SAMP8) and Senescence-Accelerated Resistant Mice 1 (SAMR1). Methods: We used 6-month-old SAMP8 and SAMR1. Sepsis was induced using cecal ligation and puncture (CLP). The animal's hippocampi and blood were collected for subsequent investigations 24 h after surgery. Results: Long-term potentiation (LTP) was impaired in the Shaffer-collateral (SC)-CA1 pathway of the hippocampus in SAMP8 without surgery compared to the age-matched SAMR1, which was reflective of cognitive dysfunction in SAMP8. CLP impaired the SC-CA1 LTP in SAMR1 compared to the sham-operated controls, but not in SAMP8. Moreover, CLP decreased the input-output curve and increased the paired-pulse ratio in SAMP8, suggesting the reduced probability of basal synaptic transmission due to sepsis. Immunohistochemical analysis revealed that CLP elevated IL-1β levels, especially in the hippocampi of SAMP8 with microglial activation. In vivo peripheral IL-1 receptor antagonist (IL-1ra) administration in the septic SAMP8 revealed that the neuroinflammation was not correlated with the peripheral elevation of IL-1β. Ex vivo IL-1ra administration to the hippocampus ameliorated LTP impairment in SAMR1 and the reduction in basal transmission in SAMP8 after sepsis. Conclusions: The mechanism of the modulation of synaptic transmission and synaptic plasticity by the acute stage of sepsis differed between SAMR1 and SAMP8. These changes were related to centrally derived IL-1 receptor-mediated signaling and were accompanied by microglial activation, especially in SAMP8.
  • ECMO補助下の呼吸不全患者の航空搬送経験
    糸洲 佑介; 斉藤 仁志; 打浪 有可; 本間 慶憲; 吉田 知由; 干野 晃嗣; 西川 直樹; 森本 裕二
    日本集中治療医学会雑誌, 27, 6, 491, 492, (一社)日本集中治療医学会, 2020年11月
    日本語, 30歳代女性。呼吸困難を主訴に近医を受診し、間質性肺炎の急性増悪と診断され加療されたが症状は改善せず、当院(札幌市)に転院となった。ただちに気管挿管し人工呼吸療法を開始したが、呼吸不全が進行し、転院3日目にVV-ECMOを導入した。その後、人工呼吸器を離脱したが、自己肺の改善はみられず、ECMOの離脱は困難な状態となり、東北大学病院へ転院し生体肺移植を受ける予定となった。転院26日目に北海道庁に災害派遣要請を行い、36日目に、高度な医療監視が行える機動衛生ユニットを有するC-130H型輸送機で航空自衛隊千歳基地から仙台空港へ搬送され、仙台空港から救急車で東北大学病院へ搬送された。一般にECMO患者の搬送は機器の脱落やライントラブルの危険性があるが、本例ではECMO装置とシリンジポンプが装着可能なバックボード装着型架台システム(BBT-2000)を使用したことでライントラブルを回避でき、移動時間の短縮にも繋がったと考えられた。
  • 血清抗O157LPS抗体を用いて腸管出血性大腸菌感染症と診断した小児溶血性尿毒症症候群の1例
    土岐 崇幸; 斉藤 仁志; 久保 康則; 秋田 敬介; 佐々木 慶子; 森本 裕二
    日本臨床麻酔学会誌, 40, 5, 485, 489, 日本臨床麻酔学会, 2020年09月
    日本語
  • 血清抗O157LPS抗体を用いて腸管出血性大腸菌感染症と診断した小児溶血性尿毒症症候群の1例
    土岐 崇幸; 斉藤 仁志; 久保 康則; 秋田 敬介; 佐々木 慶子; 森本 裕二
    日本臨床麻酔学会誌, 40, 5, 485, 489, 日本臨床麻酔学会, 2020年09月
    日本語
  • 術前心血管合併症低リスク患者において肝切除術中に心筋梗塞をきたした一例
    八木 泰憲; 水野谷 和之; 森 敏洋; 斉藤 仁志; 森本 裕二
    Cardiovascular Anesthesia, 24, Suppl., 140, 140, (一社)日本心臓血管麻酔学会, 2020年09月
    日本語
  • Cantrell症候群に合併した大動脈縮窄複合に対するNorwood手術の一例
    坂井 俊朗; 斉藤 仁志; 水野谷 和之; 田中 暢洋; 森本 裕二
    Cardiovascular Anesthesia, 24, 1, 127, 130, (一社)日本心臓血管麻酔学会, 2020年08月
    日本語
  • 老化促進マウスを用いた敗血症急性期の海馬神経炎症とミクログリア活性化の検討
    干野 晃嗣; 打浪 有可; 内田 洋介; 斉藤 仁志; 森本 裕二
    日本神経麻酔集中治療学会プログラム・抄録集, 24回, 24, 24, 日本神経麻酔集中治療学会, 2020年08月
    日本語
  • Cantrell症候群に合併した大動脈縮窄複合に対するNorwood手術の一例
    坂井 俊朗; 斉藤 仁志; 水野谷 和之; 田中 暢洋; 森本 裕二
    Cardiovascular Anesthesia, 24, 1, 127, 130, (一社)日本心臓血管麻酔学会, 2020年08月
    日本語
  • ビデオ喉頭鏡McGRATH MACを用いて気管チューブ交換を行った際に、外科的止血を要する右扁桃損傷を生じた1症例
    前田 洋典; 西田 紳悟; 水野谷 和之; 森 敏洋; 斉藤 仁志; 森本 裕二
    臨床麻酔, 44, 6, 869, 871, 真興交易(株)医書出版部, 2020年06月
    日本語, 症例は50歳代男性で、左室補助人工心臓植込み術後、両側膿胸に対して両側胸腔ドレナージ中であった。排液が減少したため両側の胸腔ドレーンが抜去されたが、1時間半後より呼吸状態が悪化し、左胸壁ドレーン抜去部からの出血が疑われた。呼吸状態安定化のために気管挿管され、左胸腔内出血に対する胸腔鏡下血腫除去止血術および右膿胸に対する胸腔鏡下膿胸掻爬術を予定した。術後は気管挿管下にICU帰室予定であったため、麻酔導入時同様にビデオ喉頭鏡(McGRATH MAC)のブレード4を使用しチューブ交換を行った。ICU帰室準備中に多量の口腔内出血を認め、何度か口腔内吸引を行ったがおさまらず、ICU帰室後に耳鼻科医に診察を依頼した。前口蓋弓-後口蓋弓を数針圧縮縫合して止血することができ、原病に対しての抗凝固療法は術翌日より再開し、その後、新規出血なく経過した。
  • 全身麻酔導入時の脳循環変化 時間分解近赤外分光法と経頭蓋ドプラを用いた前向き観察研究
    副島 崇旨; 内田 洋介; 斉藤 仁志; 森本 裕二
    麻酔, 69, 5, 530, 537, 克誠堂出版(株), 2020年05月
    日本語
  • 【ICU治療指針 III】手術・麻酔と周術期管理 成人肝移植術の周術期管理(術後管理を中心に)
    斉藤 仁志; 加藤 裕貴; 森本 裕二
    救急・集中治療, 31, 4, 1523, 1528, (株)総合医学社, 2020年03月
    日本語
  • 【ICU治療指針 III】手術・麻酔と周術期管理 小児肝移植の周術期管理
    斉藤 仁志; 干野 晃嗣; 森本 裕二
    救急・集中治療, 31, 4, 1529, 1532, (株)総合医学社, 2020年03月
    日本語
  • 【ICU治療指針 III】手術・麻酔と周術期管理 周術期の血液製剤の用い方
    斉藤 仁志; 水野谷 和之; 森本 裕二
    救急・集中治療, 31, 4, 1584, 1589, (株)総合医学社, 2020年03月
    日本語
  • 【ICU治療指針 III】手術・麻酔と周術期管理 周術期の血液製剤の用い方
    斉藤 仁志; 水野谷 和之; 森本 裕二
    救急・集中治療, 31, 4, 1584, 1589, (株)総合医学社, 2020年03月, ［査読有り］
    日本語
  • 【ICU治療指針 III】手術・麻酔と周術期管理 小児肝移植の周術期管理
    斉藤 仁志; 干野 晃嗣; 森本 裕二
    救急・集中治療, 31, 4, 1529, 1532, (株)総合医学社, 2020年03月, ［査読有り］
    日本語
  • Changes of Cerebral Blood Volume During Robot-Assisted Laparoscopic Radical Prostatectomy: Observational Prospective Study Using Near-Infrared Time-Resolved Spectroscopy.
    Nobuhiro Tanaka; Masataka Yamamoto; Takashige Abe; Takahiro Osawa; Ryuji Matsumoto; Nobuo Shinohara; Hitoshi Saito; Yosuke Uchida; Yuji Morimoto
    Journal of endourology, 33, 12, 995, 1001, 2019年12月, ［査読有り］, ［国際誌］
    英語, 研究論文（学術雑誌）, Purpose:
    Robot-assisted laparoscopic radical prostatectomy (RARP) requires a steep head-down tilt and pneumoperitoneum, which may cause an increase in cerebral blood volume (CBV). With a new near-infrared time-resolved spectroscopy device, the tNIRS-1, we can measure the absolute value of the cerebral hemoglobin concentration and hence calculate CBV and cerebral oxygen saturation (rSO2). Using this device, we evaluated the time course of CBV during surgery and also evaluated the changes in rSO2 simultaneously.
    Materials and Methods:
    We performed a prospective observational study of 21 patients scheduled for RARP. We evaluated CBV and rSO2 by using the tNIRS-1 at 10 time points during surgery.
    Results:
    The CBV was 2.92 ± 0.38 mL ·100 g-1 after the end of anesthetic preparation. It significantly increased to 3.05 ± 0.44 mL ·100 g-1 after the head-down tilt and was around 3.1 mL ·100 g-1 until 120 minutes after the head-down tilt. However, just before the return to the horizontal position, it decreased to 2.93 ± 0.46 mL ·100 g-1 and then decreased more after the return to the horizontal position. Changes in rSO2 over time were within only 3%, and no significant differences from the control value were observed.
    Conclusions:
    The increase in CBV was <10% despite the steep head-down tilt and pneumoperitoneum, and it was compensated for at around the end of surgery. Clinically significant changes in rSO2 were not observed during the surgery.
  • Acute compartment syndrome of the lower leg causing cardiac arrest after resection of the right external iliac vein for autologous graft: a case report
    Koji Hoshino; Toru Nakamura; Mineji Hayakawa; Yusuke Itosu; Hitoshi Saito; Satoshi Hirano; Yuji Morimoto
    JA clinical reports, 5, 1, 65, 65, 2019年10月23日, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: The right external iliac vein (REIV) is often used for portal vein reconstruction in patients undergoing pancreatoduodenectomy with portal-superior mesenteric vein resection. We report a case of cardiac arrest caused by acute lower leg compartment syndrome as a result of REIV resection. CASE PRESENTATION: A 53-year-old man underwent pancreatoduodenectomy with portal vein resection. Hyperkalemia progressed during surgery due to intestinal reperfusion injury, which caused recurrent ventricular arrhythmia required for cardio-pulmonary resuscitation. The surgery was discontinued after resuscitation, and portal vein reconstruction using the REIV was performed 2 days post-operatively. Acute compartment syndrome was diagnosed immediately following the surgery. Hyperkalemia progressed, causing pulseless ventricular tachycardia. Emergent fasciotomy was performed, but right leg dysfunction persisted after discharge. CONCLUSION: REIV resection can cause lower-extremity acute compartment syndrome. The status, including intracompartmental pressure, of the lower extremity should be carefully observed after REIV resection during and after surgery.
  • 不可逆的な高度心機能低下を呈した副腎外褐色細胞腫症例に対する麻酔経験
    副島崇旨; 水野谷和之; 安藤義崇; 斉藤仁志; 森敏洋; 森本裕二
    麻酔, 68, 10, 1099, 1102, 克誠堂出版(株), 2019年10月, ［査読有り］
    日本語, 19歳男。湿性咳嗽を主訴に近医を受診し、感冒の診断で内服加療されたが改善せず、10日後に呼吸困難で救急搬送された。諸検査の結果から副腎外褐色細胞腫とカテコールアミン心筋症を強く疑い、全身麻酔下に腫瘍摘出術を施行した。一般に褐色細胞腫の術中管理ではカテコールアミンサージに備えるためにα遮断薬やβ遮断薬の投与が行われ、薬物による循環維持が困難な場合は体外循環も考慮される。本例では麻酔導入後の血圧低下に対してドブタミンとノルアドレナリンを投与し、結果的に有効な循環を確立できた。手術開始後は予想に反してカテコールアミンサージによる血圧上昇を認めず、これは本例が高度な心機能低下状態であったことに加え、内部壊死を伴う副腎外褐色細胞腫であったことと関係があると考えられた。
  • 小児開心術における中枢神経障害 麻酔薬の中枢神経毒性
    斉藤 仁志; 内田 洋介; 干野 晃嗣; 打浪 有可; 森本 裕二
    Cardiovascular Anesthesia, 23, Suppl., [SY4, 3], (一社)日本心臓血管麻酔学会, 2019年09月, ［査読有り］
    日本語
  • 生体肺移植待機中に膜型人工肺(V-V ECMO)が導入された患者に高流量鼻カヌラ療法(HFNC)を併用することによって安全に麻酔導入が出来た一症例
    黒川 達哉; 田中 暢洋; 坂井 俊朗; 糸洲 佑介; 斉藤 仁志; 森本 裕二
    Cardiovascular Anesthesia, 23, Suppl., [DP2, 01], (一社)日本心臓血管麻酔学会, 2019年09月, ［査読有り］
    日本語
  • 小児麻酔のいま 1 麻酔薬の神経毒性~その基礎と臨床,過去と未来~
    斉藤仁志; 内田洋介; 森本裕二
    臨床麻酔(シービーアール), 43, 6, 790, 798, 真興交易(株)医書出版部, 2019年06月
    日本語
  • Anesthetic management for cesarean section in a patient receiving transplacental treatment of fetal tachyarrhythmia: a case report.
    Nobuhiro Tanaka; Tomoaki Fujii; Niina Mikami; Yuka Uchinami; Hitoshi Saito; Yuji Morimoto
    JA clinical reports, 5, 1, 31, 31, 2019年05月07日, ［査読有り］, ［国際誌］
    英語, 研究論文（学術雑誌）, BACKGROUND: Although rare, long-lasting fetal tachyarrhythmia often leads to fetal heart failure and hydrops. Some mothers receive transplacental treatment of fetal tachyarrhythmia (TTFT), which can potentially worsen maternal hypotension and bradycardia. Moreover, the use of rescue cardiovascular agents intraoperatively can worsen fetal tachycardia. However, reports of the anesthetic management of patients receiving TTFT are rare. CASE PRESENTATION: A 31-year-old woman who was receiving digoxin and sotalol for TTFT underwent planned elective cesarean section. The fetus had hypoplastic left heart syndrome, hydrops, and tachycardia. We used combined spinal-epidural anesthesia with a reduced dose of local anesthetic. We also employed a non-invasive continuous hemodynamic monitoring system. The mother's systolic blood pressure remained at ≥ 90% of the baseline value; intraoperative administration of rescue cardiovascular agents was not required. CONCLUSIONS: We successfully anesthetized a woman for cesarean section, who was receiving TTFT for fetal tachyarrhythmia, using combined spinal-epidural anesthesia and non-invasive continuous hemodynamic monitoring.
  • 幼児の神経芽腫に合併した可逆性脳血管攣縮症候群の1症例
    土岐 崇幸; 干野 晃嗣; 武田 圭史; 西川 直樹; 斉藤 仁志; 森本 裕二
    日本集中治療医学会雑誌, 26, 3, 199, 200, (一社)日本集中治療医学会, 2019年05月, ［査読有り］
    日本語, 2歳女児。3週前より時折嘔吐し、意識障害を認め救急搬送された。高血圧と頻脈があり強直性間代性痙攣を認めたため、気管挿管されICUに搬送された。腹部造影CTでは左後腹膜腔に径63×59×73mmの腫瘤性病変を認め、腹部大動脈と左腎動静脈を巻き込み左腎萎縮と造影効果の低下を認め、生検で神経芽腫と診断された。カテコラミン産生腫瘍による高血圧と頻拍、可逆性後頭葉白質脳症による意識障害を疑った。心不全に対しnicardipine持続静注とamlodipineおよびcarvedilol経口投与を開始し、enalapril経口投与を追加してnicardipine持続静注を終了した。第3病日に全身強直性間代性痙攣を認め、MRAでは両側後大脳動脈や前大脳動脈で不整狭窄像とapparent diffusion coefficient低下や拡散強調像で高信号を認め、標記の診断とした。深鎮静管理として第8病日のMRAで脳血管攣縮は改善したが脳萎縮は進行し、意識障害が遷延した。
  • Isoflurane induced c-Fos expression in the area postrema of the rat.
    Hase T; Hashimoto T; Saito H; Uchida Y; Kato R; Tsuruga K; Takita K; Morimoto Y
    Journal of Anesthesia, 33, 4, 562, 566, 2019年, ［査読有り］, ［国内誌］
    英語, 研究論文（学術雑誌）, INTRODUCTION: Volatile anesthetics are speculated to cause postoperative nausea and vomiting via stimulation of the chemoreceptor trigger zone (CTZ). However, the precise mechanism underlying the emetic action of these drugs is not well understood. In this study, we assessed whether isoflurane induced the expression of c-Fos, a neuronal activation marker, in the area postrema (AP), the locus of the CTZ, in rats, which do not have vomiting action. MATERIALS AND METHODS: Male rats were exposed to 1.3% isoflurane for 0-240 min, or to various concentrations of isoflurane (0, 1.3%, or 2.6%) for 120 min. Finally, the rats were exposed to 1.3% isoflurane for 120 min after ondansetron administration. After the treatments, immunohistochemistry of the rat AP was performed using c-Fos antibody staining. RESULTS: One-way analysis of variance showed that isoflurane exposure significantly increased c-Fos expression in the AP; however, the rats pretreated with 4 mg/kg ondansetron showed significantly decreased c-Fos expression. Moreover, we evaluated the effect of the anesthetic on inducing pica in the rats, and found that kaolin intake was not influenced by isoflurane exposure. CONCLUSION: Overall, these results suggest that isoflurane activates AP neurons and may be involved in the emetic mechanism of isoflurane. This study further suggests the feasibility of using rats as a model for studying emetic mechanisms of drugs, despite their lack of vomit action.
  • Evaluation of external reference levels for central venous pressure measurements of severely obese patients in the supine position.
    Mizunoya K; Saito H; Morimoto Y
    Journal of anesthesia, 32, 4, 558, 564, 2018年08月, ［査読有り］, ［国内誌］
    英語, 研究論文（学術雑誌）, PURPOSE: A proper reference level is important for measuring intracardiac pressures, especially for parameters with small normal values such as central venous pressure (CVP). Although several external zero reference levels (eZRLs) have been proposed for non-obese patients, none has been reported for severely obese patients. The aim of this study was to investigate an appropriate eZRL for CVP measurements of severely obese patients. METHODS: Chest computed tomography images of 65 patients with body mass index (BMI) ≥ 35 kg/m2 were retrospectively reviewed. The anteroposterior thoracic diameter and height of the mid-right atrium (RA) were measured. Four reported eZRLs for CVP measurements (midthoracic level, two-thirds and four-fifths of the thoracic diameter above table level, and 5 cm below the anterior thorax) were examined for error when predicting the midpoint of the RA. RESULTS: The median BMI was 36.9 kg/m2 [interquartile range (IQR), 36.0-39.2]. There was a significant difference in the calculated errors for the midpoint of the RA among the four eZRLs (Kruskal-Wallis test, P < 0.001). Two-thirds of the thoracic diameter above table level was the most accurate reference level for CVP measurement (Steel-Dwass post hoc analysis, P < 0.001). The Bland-Altman plot showed acceptable agreement for clinical use (mean difference, - 7 mm; 95% limit of agreement, - 23 to 9 mm). CONCLUSION: The most accurate eZRL for CVP measurements of severely obese patients in the supine position was two-thirds of the thoracic diameter above table level. This result is consistent with that of a previous report of non-obese patients.
  • ゲンタマイシン吸入が奏功した気管支拡張症急性増悪の一例
    武田 圭史; 土岐 崇幸; 干野 晃嗣; 斉藤 仁志; 柳田 雄一郎; 森本 裕二
    日本集中治療医学会雑誌, 25, 3, 185, 189, (一社)日本集中治療医学会, 2018年05月, ［査読有り］
    日本語
  • Influence of nitrous oxide on granule cell migration in the dentate gyrus of the neonatal rat
    Hitoshi Saito; Rui Kato; Toshikazu Hashimoto; Yosuke Uchida; Tetsutaro Hase; Kenkichi Tsuruga; Koichi Takita; Yuji Morimoto
    Biomedical Research (Japan), 39, 1, 39, 45, Biomedical Research Foundation, 2018年, ［査読有り］
    英語, 研究論文（学術雑誌）
  • Changes of Cerebral Oxygenation in Sequential Glenn and Fontan Procedures in the Same Children
    Yasunori Yagi; Masataka Yamamoto; Hitoshi Saito; Toshihiro Mori; Yuji Morimoto; Takayoshi Oyasu; Tsuyoshi Tachibana; Yoichi M. Ito
    PEDIATRIC CARDIOLOGY, 38, 6, 1215, 1219, 2017年08月, ［査読有り］, ［国際誌］
    英語, 研究論文（学術雑誌）
  • Laboratory findings: To what degree can we extrapolate the animal data to the bedside?
    Yuji Morimoto; Yosuke Uchida; Hitoshi Saito
    Anesthesia and Neurotoxicity, 3, 15, Springer Japan, 2017年05月30日
    英語, 論文集(書籍)内論文
  • Effect of age difference of cerebral oxygen saturation to predict early outcome in pediatric cardiac surgery for ventricular septal defect.
    Yasunori Yagi; Masataka Yamamoto; Hitoshi Saito; Toshihiro Mori; Yuji Morimoto; Takayoshi Oyasu; Tsuyoshi Tachibana; Yoichi M Ito
    Circulation Control, 36, 2, 106, 110, Japan Society of Circulation Control in Medicine, 2015年, ［査読有り］
    英語, 研究論文（学術雑誌）
  • Anesthetic management for severe aortic regurgitation in an infant repaired by Ross procedure
    Akira Watabe; Hitoshi Saito; Katsumi Harasawa; Yuji Morimoto
    JOURNAL OF ANESTHESIA, 23, 2, 270, 274, 2009年05月, ［査読有り］, ［国内誌］
    英語, 研究論文（学術雑誌）
■ その他活動・業績
■ 主な担当授業
  • 医学総論, 2024年, 博士後期課程, 医学研究科
  • 基本医学研究, 2024年, 修士課程, 医学院
  • 基本医学総論, 2024年, 修士課程, 医学院
  • 医学総論, 2024年, 博士後期課程, 医学院
  • 基盤医学研究, 2024年, 博士後期課程, 医学院
  • 臨床医学研究, 2024年, 博士後期課程, 医学院
  • 麻酔学, 2024年, 学士課程, 医学部
■ 共同研究・競争的資金等の研究課題
  • 老化促進モデルマウスを用いた術後高次脳機能障害ならびに認知症への麻酔・手術の影響
    科学研究費助成事業
    2018年04月01日 - 2021年03月31日
    森本 裕二; 斉藤 仁志
    加齢・認知機能障害合併マウスにおいて、麻酔・手術が認知機能に及ぼす影響を検討した。結果は、通常マウスにおいては、手術後にのみ神経炎症が増強していたのに比較して、加齢・認知機能障害合併マウスでは、麻酔暴露のみでも海馬における炎症性サイトカインの上昇を認め、神経炎症の増強を明らかにした。
    しかし、行動学試験においては加齢・認知機能障害合併マウスの、術後認知機能障害について検出できなかった。理由としては、麻酔・手術を行わないコントロール群で既に認知機能が大幅に低下しており、麻酔・手術の影響を検出することができなかったためと考えている。
    日本学術振興会, 基盤研究(C), 北海道大学, 18K08843
  • 吸入麻酔薬が幼若ラット海馬歯状回の顆粒細胞移動に及ぼす影響
    科学研究費助成事業
    2014年04月01日 - 2018年03月31日
    橋本 聡一; 斉藤 仁志; 長谷 徹太郎
    動物モデルにおいては、幼若期に麻酔薬を投与すると神経変性や成長後の行動異常を引き起こすことが報告されている。一方、熱性けいれんモデルのラットでは、幼若期の海馬歯状回において、過剰なγ-アミノ酪酸（GABA）A受容体を介する信号が顆粒細胞の正常な移動を阻害することが報告されている。吸入麻酔薬はGABA性の作用を持つことが知られている。本研究では、免疫組織学的手法により、幼若期のラットに吸入麻酔薬を投与すると、海馬歯状回の顆粒細胞の移動が阻害されること、およびGABA(A)受容体がその抑制作用に関与していることを明らかにした。
    日本学術振興会, 基盤研究(C), 北海道大学, 26462325